Complications Research Study
Complications of Diabetes among Aboriginal Canadians: Increasing our Understanding of Prevalence and Risk Factors
Diabetes, over time, can cause damage to a number of areas of the body, including the eyes, the kidneys, the feet and the heart and large blood vessels. Despite the very high prevalence of diabetes among Aboriginal Canadians, we actually know very little about the burden these complications and the risk factors for their development.
The aims of this part of the project are to determine the prevalence (amount) of complications of the eyes, feet, kidneys, heart and blood vessels among people with diabetes in Sandy Lake, and to better understand the risk factors for developing these complications.
We are using a number of approaches to test for the early signs of diabetic complications and associated risk factors. These methods are rapid, painless, relatively inexpensive, and can be easily used by community-based workers. They are therefore appropriate for use in remote communities. These methods are outlined below:
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Kidney damage("nephropathy"): We are testing for the early signs of kidney damage using the albumin:creatinine ratio in a random daytime urine sample. The CA-2000+, a "point of care" machine that gives results immediately, is being used for this test. Eye damage("retinopathy"): We are screening for the early signs of eye damage using a special camera that takes digital (computerized) pictures of the back of the eye, which are sent over the internet to an eye specialist in Thunder Bay for evaluation. The camera is easy to use, and drops to dilate the pupil are not required. Damage to the feet ("neuropathy"): We are testing for the early signs of nerve damage using the Michigan Neuropathy Screening Instrument, which consists of a series of quick, painless procedures to test ankle reflexes, vibration perception, and sensation in the feet. Damage to the heart and large blood vessels("atherosclerosis"): |
 fasting (blood test ) |
 eye exam |
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 Foot test |
We are looking at the blood vessels in the neck using an ultrasound scanner, which uses sound waves to look inside the body. In addition, we are measuring blood pressure in the legs using a blood pressure cuff and special stethoscope, which also uses sound waves. These measurements will help us to determine whether a person is at risk for a heart attach, stroke or leg problems.
 questionnaire |
 neuropathy test |
We are measuring potential risk factors for complications, such as high blood sugar (using hemoglobin A1c tests), high levels of fats in the blood, low levels of exercise, diet, family history, smoking, alcohol intake and stress. If the complications of diabetes are detected early, treatments are available that can slow or prevent their progression. In addition, understanding which risk factors are associated with complications can help to design prevention programs.